What is carotid stenosis?
Carotid stenosis is a condition in which the carotid artery, typically in the neck, is narrowed. This happens most often because of plaque buildup inside the artery, called atherosclerosis. As plaque builds, the artery becomes narrower and less blood is able to flow into the brain. Risk factors for developing atherosclerosis include:
- High blood pressure
- High cholesterol
What are the symptoms of carotid stenosis?
Carotid stenosis causes transient ischemic attacks (TIAs). These “mini-strokes” result from a temporary disruption of blood flow into the brain. They cause stroke-like symptoms, but don’t result in permanent damage or loss of function. Carotid stenosis can also cause strokes (and people who experience TIAs are at a higher risk of stroke), so pay attention to the warning signs.
It is important to know and recognize the most common signs of a stroke and call 911 immediately if you or someone around you experience them. Symptoms of a stroke usually appear suddenly, and the sooner you get treatment, the better the outcome. These symptoms include:
- Weakness, numbness or paralysis – often on one side of the body
- Drooping on one side of the face
- Difficulty speaking or understanding speech
- Loss of balance or coordination or difficulty walking
- Vision problems
- Loss of consciousness
How is carotid stenosis diagnosed?
If you experience a TIA, our team of cerebrovascular specialists will use a variety of advanced imaging techniques to help determine if carotid stenosis is the cause. These include:
- Carotid Doppler ultrasound is widely used for evaluating carotid vascular disease. The velocity of the flow of blood through the carotid artery is used to determine the degree of plaque buildup in the artery.
- Magnetic resonance angiography (MRA) is a noninvasive procedure that uses various magnetic resonance imaging (MRI) techniques to produce images of the insides of the blood vessels.
- Computed tomography angiography (CTA) is a noninvasive test that uses injected contrast dye and CT scanning to identify narrowing of the blood vessels.
- Cerebral angiography is a procedure where a catheter injects contrast dye to provide the most detailed images of the blood vessels of the neck and brain. This procedure also assesses blood flow through the vessel.
How is carotid stenosis treated?
At UCLA, a multidisciplinary team of neurovascular experts will meet to review your case and create a customized treatment plan. Treatment may include:
- Medical management: Options include aspirin or other antiplatelet medications, anticoagulant medication, blood pressure and cholesterol-fighting medications and intervention to help patients stop smoking.
- Carotid endarterectomy: This procedure is used to surgically open the artery and remove the plaque to improve blood flow. Among patients with greater than 70 percent blockage, using endarterectomy reduces the rate of stroke over the next two years by 17 percent and the risk of major stroke or death by 10.6 percent compared to medical management.
- Carotid artery angioplasty and stenting: This procedure is performed from the inside of the blood vessels. The surgeon uses a balloon to dilate the region of stenosis and inserts a stent to hold the vessel open and improve flow.
To schedule an appointment at the UCLA Cerebrovascular Program, please call 310-825-5111 or click here to request an appointment.